Osteoarthritis versus Rheumatoid Arthritis

One of the most commonly used words in medicine is ‘arthritis’, but did you know that there are  different types of arthritis?   Arthritis literally means ‘joint inflammation’.    This is consistent across all types of arthritis, but the symptoms can look very different.   This article will highlight some differences between two of the main types: osteoarthritis (OA) and rheumatoid arthritis (RA).

The most common type of arthritis is osteoarthritis.  Osteoarthritis occurs when the cartilage in a joint breaks down.  Cartilage is the tissue on the ends of our bones that helps to add cushioning to our joints.   As the cartilage wears away, there is less padding in the joint and it can feel stiff, tight, crunchy, or painful.  Usually, this stiffness is worst in mornings or after long periods of inactivity, but it responds well to movement such as stretching and gentle range of motion.

Osteoarthritis is a localized joint disease.  It does not affect other body/organ systems.  It is associated with joint overuse, aging, and prior injury.  The most common joints that develop osteoarthritis are weight-bearing joints such as the knees, hips, and spine.  Any joint can develop osteoarthritis, however, and it becomes much more likely if you have experienced injury to that area in the past.

Osteoarthritis is a progressive disease, but it progresses slowly and the severity varies greatly from person to person.  As it progresses, people may begin to experience joint pain with minimal activity, joint swelling, and joint stiffness.

Physical therapy is indicated to treat osteoarthritis. Physical therapy will help restore range of motion, strengthen supporting structures, reduce pain and improve tolerance to activity.  Additional treatments that can be used in conjunction with physical therapy are pain relievers like Tylenol or non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, lifestyle changes, and in severe cases, joint replacement.

Rheumatoid arthritis is an autoimmune disease.  This means that the body’s immune system mistakenly attacks a part of the joint called the synovium, which is the lining of the joint capsule.  The exact cause of rheumatoid arthritis is not known and involves a variety of genetic and environmental factors.

Rheumatoid arthritis usually presents with joint pain, swelling, warmth, and redness in multiple joints at the same time.  It often begins in a symmetrical pattern, meaning the same joint will be affected on each side of your body.  It also usually begins in smaller joints like the fingers and hands.  This type of arthritis is associated with chronic inflammation and structural joint changes such as cartilage loss, bony deformity, and bone erosion.  It is also a systemic disease, meaning it affects other parts of the body and organ systems.  This means that in addition to joint stiffness, people with RA can experience immune responses like fever, fatigue, and weight loss.  These types of symptoms usually come in waves, as the disease process is characterized by periods of flared symptoms followed by improvements in symptoms.

Treatment of RA includes disease-modifying anti-rheumatic drugs (DMARDs), corticosteroids, NSAIDS, lifestyle changes, and physical therapy.   Physical therapy for RA includes many of the same concepts as for OA, but it will also focus on task modification and use of adaptive equipment to protect your joints and allow you to continue doing activities that are important to you.

It is important to remember that all types of arthritis can be managed by physical therapy. Discussing your symptoms and limitations with your physical therapist will allow them to develop an individualized plan of care to help you meet your goals.  Call to set up an appointment at Lifeline Therapy for your arthritis today!

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